Abstract:The widespread global prevalence of hypovitaminosis D during pregnancy and its implications for undesirable health outcomes in present and future generations is an area of growing concerns. The study was undertaken with an aim to determine vitamin D status among pregnant women and their new-borns and to find association between maternal vitamin D level during pregnancy and neonatal outcome. This hospital based, observational study was conducted on 250 pregnant patients and their new-borns in departments of Obstetrics & Gynaecology and Paediatrics at SMS Medical College, Jaipur from May 2014 to April 2015. Maternal and cord blood samples were drawn at the time of delivery for 25-hydroxy vitamin D, S. calcium, S. phosphorus and S. ALP levels estimation. 86% of women were vitamin D deficient, 12.4% insufficient and only 1.6% had sufficient vitamin D levels. Their new born also showed similar results. Mean neonatal vitamin D level in vitamin D deficient , insufficient , sufficient mothers were 5.73 ± 2.7 ng/ml, 17.77 ± 9.62 ng/ml and 33.09 ± 5.22 ng/ml respectively. Maternal and cord blood vitamin D levels showed significant positive correlation (r = 0.90, P value < 0.001). Maternal Vitamin D status was not significantly associated with neonatal biochemical parameters (S. calcium, S. phosphorus and S. ALP levels) and anthropometry. The strong correlation between 25(OH) D concentrations in mothers and their new-borns indicate that adequate vitamin D intake for mothers should be emphasized through maternal supplementation which would achieve the double effect of preventing vitamin D deficiency in both mothers and children.

Background: Ovarian tumors usually presents as adnexal masses which may be benign or malignant. Accurate and timely diagnosis of an adnexal mass is a challenge for the gynecologists. Currently clinical examination, ultrasonographic assessment and ovarian tumour markers (CA 125, beta hCG, AFP, LDH) are routinely done at our centre to evaluate patients with ovarian tumours. The study was designed to evaluate the ability of RMI 4 to discriminate benign ovarian tumor from malignant ovarian tumor in patients attending Department of Obstetrics and Gynaecology, S.M.S. Medical College, Jaipur.Methods: 200 patients diagnosed to have ovarian tumours were included in the study after obtaining written consent. Ultrasonographic characteristic, menopausal status and serum CA 125 levels were documented preoperatively. Risk of malignancy index 4 was calculated and correlated with histopathological diagnosis.Results: At a cut-off point of 450, RMI 4 had a sensitivity of 67.5% (95% CI: 50.87-81.43%), specificity of 98.75% (95.56-99.85%), positive likelyhood ratio of 54, negative likelyhood ratio of 0.33, a positive predictive value of 93.1%, negative predictive value of 92.4% and diagnostic accuracy of 92.5%.Conclusions: RMI 4 is a simple, cost effective, reliable scoring system that is easily applicable method in primary evaluation of patients with ovarian tumours with a sensitivity of 67.5% and specificity of 98.75%.

Early pregnancy failure a b s t r a c tBackground: Nearly 20% of all confirmed pregnancies end in spontaneous abortion. Misoprostol's use in early pregnancy failure is varied and dose and route are not well established. The aim of this study was to compare the efficacy and the side effects of different regimes of misoprostol in causing expulsion of products of conception in early pregnancy failure.Method: Women patients with an ultrasound diagnosis of early pregnancy failure, less than 12 weeks gestation were divided into two, Group-A: tab. Misoprostol 800 mcg 6 hourly vaginally, upto 3 doses. Group-B tablet misoprostol 600 mcg 6 hourly, sublingually for 3 doses. All observations were noted and statistical analyzed.Results: Mean gestational age was 7.93 weeks. Mean induction abortion interval 18.183 h.Women patients with less than six weeks gestational age had least mean inductionabortion interval time, 15.75 ± 2.82 h in vaginal group but was highest in sublingual group 22 ± 2 h and 18.43 h in overall (P ¼ 0.02). Though after 8 weeks, both routes were equally effective. Mean dose required in group-A was 20044 mcg and in group-B was 1564 mcg (P < 0.001). Efficacy of protocol was 88.89% in group-A and 92.85% in group-B. Conclusion:Both regimes had comparable efficacy, acceptability (90%) and side effects. In women patients less than six weeks period of gestation, the vaginal (800 mcg) route was distinctly superior, in women patients with 6e8 weeks the sublingual (600 mcg) route was more advantageous. The correct dose must be used for the route chosen. The route of administration should be decided in accordance with the preference of the patient and the clinical situation.© 2014, Armed Forces Medical Services (AFMS). All rights reserved.* Corresponding author. Tel.: þ91 (0)9828025302 (mobile). E-mail address: hoojasjaipur@gmail.com (N. Hooja).Available online at www.sciencedirect.com ScienceDirect journal homepage: www .e lsev ie r. co m/ lo cate/ mj afi m e d i c a l j o u r n a l a r m e d f o r c e s i n d i a 7 0 ( 2 0 1 4 ) 3 6 0 e3 6 3 http://dx

INTRODUCTIONEctopic pregnancy (EP) is the leading cause of maternal death during the first trimester of pregnancy, accounting for approximately 10% of all pregnancy-related deaths. 1 It still remains a serious health problem for women of childbearing age.2 A ruptured ectopic pregnancy is a true medical emergency. Morbidity due to ectopic pregnancy is in the form of infertility and ectopic recurrence. Although the total number of intrauterine pregnancies has declined over the past three decades, there has been a rise in the incidence of ectopic pregnancy as a result of an increased and persistent exposure to its risk factors and partially due to improved ability in making an earlier diagnosis. 4,5 As the morbidity and mortality associated with extrauterine pregnancy are directly related to the length of time required for diagnosis, the increased awareness and knowledge of the risk factors for it could enable an early and accurate diagnosis of the disease, resulting in earlier intervention.Numerous studies have been done to explore the risk factors for ectopic pregnancy and it was found that the main risk factors for ectopic pregnancy are conditions or procedures which cause tubal damage. The exact role and strength of these factors have not been definitively determined. Very few studies have been done in our state to find various risk factors for ectopic pregnancy therefore; the present study was designed to identify potential risk factors and to evaluate their contribution in ectopic pregnancy. ABSTRACTBackground: Morbidity and mortality associated with ectopic pregnancy are directly related to the length of time required for diagnosis. Knowledge of risk factors for ectopic pregnancy will help an obstetrician to suspect and diagnose the condition early. Therefore, the present study was designed to identify potential risk factors and to evaluate the contribution of the risk factors in ectopic pregnancy. Methods: Study population consists of 65 women with ectopic pregnancy and for each ectopic case one woman with first trimester intrauterine pregnancy was recruited as control. Data were retrieved from all through a structured proforma. Data were analyzed statistically. Results: Various significant risk factors for ectopic pregnancy found were pelvic inflammatory disease, tubal ligation, age above 30 yrs, previous use of IUCD, low socio-economic status, tubal infertility and genital tuberculosis while no significant association was seen with smoking, age below 30 years, history of prior induced abortion, oral contraceptive pills and clomiphene citrate. Conclusions: Increase awareness and knowledge of risk factors will help obstetricians to suspect and diagnose ectopic pregnancy early and accurately and enable them to plan medical treatment. Surgical treatment will be reserved for ruptured ectopic pregnancy and haemodynamically unstable patients.

Introduction: Abnormal uterine bleeding (AUB) is a common disorder occurring in reproductive age group females. It can be understood as bleeding that occurs from the uterus outside the normal parameters and there is no structural defects in the genital tract. One of the most common association with AUB is thyroid dysfunctions. Hence this study aimed to see the incidence of thyroid related disorders in AUB and also to assess the menstrual pattern. Material and Methods: 100 women suffering from AUB who presented to OPD of Gynecology department of SMS Medical College, Jaipur were recruited in the study. All females in 19 to 45 years of age group with abnormal uterine bleeding were included excluding those with previously known thyroid disorder, abortion history within 3 months etc. Thyroid function tests were done in all along with ultrasonography of pelvis region. Statistical analysis done. Results: The bleeding abnormality that was found in the most of the women was heavy menstrual bleeding. Women who presented with thyroid dysfunction were 33%. 23% had subclinical hypothyroidism, 6% had hypothyroidism and 4% had hyperthyroidism. Conclusion: Abnormal Uterine Bleeding has strong association with thyroid disorders. Most common type of disorder is subclinical hypothyroidism.Thus all patient of AUB must be evaluated for thyroid dysfunction